Individual
DUSTIN DRATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
500 RUSSELL DR W, HOLMEN, WI 54636-8845
(920) 538-2148
Mailing address
500 RUSSELL DR W, HOLMEN, WI 54636-8845
(920) 538-2148
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5454-26
WI
Other
Enumeration date
09/17/2014
Last updated
09/17/2014
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